BALTIMORE — Tens of thousands of lives have been saved over the years because Americans more routinely wear seat belts and don’t drive drunk.
But there are other public health threats from those who text while driving or overdose on prescription drugs.
That’s why a group of researchers began looking at which prevention measures work and who is using them across the country to stem the rate of injuries of all kinds. Injuries are the third-leading cause of death for adults and the biggest killer of young people.
“Injuries are a huge problem hiding in plain sight,” said Andrea Gielen, director of the Johns Hopkins Center for Injury Research & Policy and co-author of a new report released by the Trust for America’s Health and the Robert Wood Johnson Foundation. “People don’t necessarily recognize the toll.”
Researchers believe it’s the first time a report has identified 10 key injury-prevention measures and which states have adopted them. They hope their findings are used to influence public policy and laws and to change individuals’ behavior.
These are the 10 measures:
• Seat belts: Have a primary seat belt law (32 states).
• Drunken driving: Have mandatory ignition interlocks for all convicted drunken drivers (16 states).
• Motorcycle helmets: Require helmets for all riders (19 states).
• Booster seats: Require seats to age 8 (33 states).
• Bicycle helmets: Require helmets for all children (21 states).
• Intimate partner violence: Allows people in dating relationships to get protection orders (44 states).
• Teen dating violence: Several measures recommended (6 states).
• Concussions: Several measures recommended, including baseline exams for school sports (36 states).
• Accidental prescription drug overdose or use: Have an active monitoring program (48 states).
• Ecodes: Include a code on patient discharge forms from emergency rooms showing the injury cause for research purposes (23 states).
Up to now, no state has adopted all of the measures. The resulting injuries are not only a health issue, but a financial one, said Jeffrey Levi, executive director of the Trust for America’s Health.
Annual federal funding for injury prevention has been cut by 24 percent in the past five years to $88.6 million, he said, and many lawmakers want to know what the return on the investment will be before boosting the money anew.
About 50 million Americans are treated for injuries every year, including 9.2 million children who are taken to emergency rooms, Levi said. About 12,000 children die from their injuries. The injuries also generate $4.6 billion in lifetime costs for medical care and lost productively.
But the report shows injury-prevention laws are making gains, he said. Seat belts saved an estimated 69,000 lives from 2005 to 2010. Motorcycle helmets saved about 8,000 lives, and child safety seats saved 1,800 from 2005 to 2009.
“There are some relatively simple and inexpensive things you can do to make a big difference,” Levi said. “If every state passed every law, millions of lives and millions of dollars would be saved.”
Nationally, the rate of death from injuries is 57.9 per 100,000 people.
Every year, public health officials lobby the state legislature or seek new regulations to ban risky behaviors, such as using cellphones while driving, and potentially harmful devices, such as crib bumpers implicated in a small number of infant suffocation deaths. This year, state health officials asked for and won approval of a law requiring children be kept in booster seats until age 8.
Another effort is under way to curb domestic violence among young people, said Frances B. Phillips, Maryland’s deputy secretary for public health services. She said the new report will give officials more data to back up their arguments for laws and funding.
“We all know injuries can be extremely tragic and can lead to death, but we don’t typically see them as preventable,” Phillips said. “But these are not random events, and we can take steps to prevent them. And when we do, the outcome is really positive.”
The report’s authors said research will continue to determine the best methods of preventing injury. Sometimes recommendations change. For example, Gielen said, children should be in booster seats until they are 8 years old and babies’ seats should remain backward until occupants are 2, longer than previously thought.
New threats are emerging that will require study to determine the best methods of prevention. They include texting while driving, prescription drug overdoses, bullying, concussions in school sports and falls among the aging Baby Boomer generation.
Once research shows what works, the public still will need convincing. Gielen noted drunken driving as an example. Laws were passed but injuries did not go down until Mothers Against Drunk Driving publicized the problem. The next step, Gielen and other researchers say, are mandatory ignition interlocks for all convicted drunken drivers.
But unintended consequences also could be a problem as new laws take effect, Levi said. For example, simply banning texting could make some drivers try to hide their phones from law enforcement, diverting their eyes longer from the road.
“There is definitely an educational component, for the lawmakers and for the public,” he said.
